The relationship between serum Lp-PLA2，SAA，PECAM-1 levels and disease severity and prognosis in patients with
type H hypertension complicated with acute cerebral infarction Zhang Manqing，Liu Junli，Xu Xiaowei，Cui Yanghu．
Department of Emergency，Haian City People＇s Hospital，Jiangsu Province，Haian 226600，China
Corresponding author: Xu Xiaowei，E-mail: qingchunwuhui0513@ 163． com
Funding program: Nantong Municipal Science and Technology Project of 2018 ( MSZ18233)
【Abstract】 Objective To analyze the correlation between the levels of serum lipoprotein phospholipase A2 ( Lp-
PLA2) ，amyloid A ( SAA) and platelet endothelial cell adhesion molecule-1 ( PECAM-1) and the severity and prognosis of a-
cute cerebral infarction ( ACI) ． Methods One hundred and eighty patients with hypertension complicated with ACI admitted
to the Emergency Department of Hai＇an People＇s Hospital from July 2021 to June 2022 were selected． According to the level of
serum homocysteine ( Hcy) ，they were divided into the observation group ( 124 patients with type H hypertension) and the
control group ( 56 patients with simple hypertension) ． The observation group was further divided into non-vulnerable plaque
subgroup ( 45 cases) and vulnerable plaque subgroup ( 79 cases) according to the results of neck ultrasound examination． Ac-
cording to the changes in the score of the National Institutes of Health Stroke Scale ( NIHSS) within 72 hours after the onset of
·272· 疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

the disease，the observation group was divided into non-early neurological deterioration subgroup ( non-END subgroup) ( 53
cases) and END subgroup ( 71 cases) ． According to the score of the modified Ｒankin Scale ( mＲS) 90 days after the onset of
the disease，the observation group was divided into a subgroup with good prognosis ( 89 cases) and a subgroup with poor prog-
nosis ( 35 cases) ． The levels of serum Lp-PLA2，SAA and PECAM-1 in each group were compared． Pearson analyzed the cor-
relation between the levels of serum Lp-PLA2，SAA，PECAM-1 and the level of Hcy，the early CT score of Alberta Stroke
Project ( ASPECTS) ，and the score of acute physiology and chronic health status scoring system II ( APACHE II) ; The effica-
cy of serum Lp-PLA2，SAA and PECAM-1 in evaluating type H hypertension complicated with ACI was analyzed by drawing
the working characteristic curve ( ＲOC) of subjects． Ｒesults Compared with the levels of serum Lp-PLA2，SAA and PE-
CAM-1，the observation group was higher than the control group ( t / P = 6． 481 /0． 005，8． 154 / ＜ 0． 001，7． 462 / ＜ 0． 001) ，
the vulnerable plaque subgroup was higher than the non-vulnerable plaque subgroup ( t / P = 7． 628 / ＜ 0． 001，8． 319 / ＜ 0．
001，8． 615 / ＜ 0． 001) ，and the END subgroup was higher than the non-END subgroup ( t / P = 7． 854 / ＜ 0． 001，8． 627 / ＜ 0．
001，9． 825 / ＜ 0． 001) ，The poor prognosis subgroup was higher than the good prognosis subgroup ( t / P = 7． 915 / ＜ 0． 001，
8． 968 / ＜ 0． 001，8． 763 / ＜ 0． 001) ． Pearson analysis showed that the serum levels of Lp-PLA2，SAA and PECAM-1 were
positively correlated with Hcy and APACHE II scores ( Hcy: r / P = 0． 691 / ＜ 0． 001，0． 725 / ＜ 0． 001，0． 674 / ＜ 0． 001; A-
PACHE II scores: r / P = 0． 591 / ＜ 0． 001，0． 640 / ＜ 0． 001，0． 683 / ＜ 0． 001) ，and negatively correlated with ASPECTS
scores ( r / P = － 0． 598 / ＜ 0． 001，－ 0． 703 / ＜ 0． 001，－ 0． 629 / ＜ 0． 001) ． The area under the curve ( AUC) of serum Lp-
PLA2，SAA，PECAM-1 and their combined detection and evaluation of type H hypertension with ACI were 0． 681，0． 709，0．
754 and 0． 924，respectively． The combined detection and evaluation efficiency of the three was higher than that of single de-
tection ( Z = 6． 863，7． 418，7． 905，P ＜ 0． 001) ． Conclusion Serum Lp-PLA2，SAA and PECAM-1 are highly expressed in
patients with type H hypertension complicated with ACI，which is closely related to the stability of carotid artery plaque，dis-
ease severity and prognosis． The combined detection of the three is of higher clinical value．
【Key words】 H type hypertension; Acute cerebral infarction; Lipoprotein phospholipase A2; Amyloid A; Platelet en-
dothelial cell adhesion molecule-1; Assessed value